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Acute General Hospital (acute + general_hospital)
Selected AbstractsNursing the clinic vs. nursing the patient: nurses' experience of a day hospital chemotherapy serviceJOURNAL OF CLINICAL NURSING, Issue 9 2006Sonja Mcilfatrick PhD Aims and objectives., This study sought to explore the nurses' experience of a day hospital chemotherapy service in an acute general hospital in Northern Ireland and how this compared with their experience of working in an inpatient setting. Background., Despite the many changes taking place in cancer care delivery, little research has been conducted on nurses' experience of working in more acute cancer treatment settings. Research conducted to date has tended to focus on the role of nurses in wards, hospices and palliative care settings. Design., This Heideggerian hermeneutic phenomenological study explored nurses' lived experience of day hospital chemotherapy service. Method., Face-to-face focused in-depth interviews were conducted with the total population of nurses who worked in the day hospital at the time of data collection (n = 10). Data analysis involved a two-staged approach, the analysis of narratives and narrative analysis, based on the work of Polkinghorne (1995). Conclusions., The nurses' viewed their experience of the chemotherapy day hospital as having both positive and negative dimensions. The positive dimensions included an increased sense of autonomy and the challenge of developing new skills, while the negative dimension included a perceived decrease in their caring role: (i),The individual characteristics of the nurse were seen to have a key influence on caring experience; (ii),Role changes led to a perceived dichotomy between their actual and aspired role and their caring and clinical role. Relevance to clinical practice., There is a need to achieve a balance between delivering a clinical role (administering chemotherapy) while maintaining the centrality of the nurse,patient relationship. This can be likened to achieving a balance between ,nursing the clinic' alongside ,nursing the patient'. These findings have implications for the discourse on caring within other outpatient type clinics and discourse on cancer nursing as therapy and the culture of the cancer clinic. [source] A 3-year study of medication incidents in an acute general hospitalJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2008L. Song MPhil Summary Background and objective:, Inappropriate medication use may harm patients. We analysed medication incident reports (MIRs) as part of the feedback loop for quality assurance. Methods:, From all MIRs in a university-affiliated acute general hospital in Hong Kong in the period January 2004,December 2006, we analysed the time, nature, source and severity of medication errors. Results:, There were 1278 MIRs with 36 (range 15,107) MIRs per month on average. The number of MIRs fell from 649 in 2004, to 353 in 2005, and to 276 in 2006. The most common type was wrong strength/dosage (36·5%), followed by wrong drug (16·7%), wrong frequency (7·7%), wrong formulation (7·0%), wrong patient (6·9%) and wrong instruction (3·1%). 60·9%, 53·7% and 84·0% of MIRs arose from handwritten prescription (HP) rather than the computerized medication order entry in 2004, 2005 and 2006 respectively. In 43·1% of MIRs, preregistration house officers were involved. Most errors (80·2%) were detected before any drug was wrongly administered. The medications were administered in 212 cases (19·7%), which resulted in an untoward effect in nine cases (0·8%). Conclusions:, The most common errors were wrong dosage and wrong drug. Many incidents involved preregistration house officers and HPs. Our computerized systems appeared to reduce medication incidents. [source] The challenges for nurses communicating with and gaining valid consent from adults with intellectual disabilities within the accident and emergency care serviceJOURNAL OF CLINICAL NURSING, Issue 9 2007Margaret Sowney MSc Aim., This paper reports the challenges experienced by nurses within accident and emergency departments in communicating with and gaining valid consent from adults with intellectual disabilities. Background., Consent is both a legal requirement and an ethical principle required to be obtained by health-care professionals, prior to the start of any examination, treatment and/or care. Central to the process of seeking consent is effective communication. However, evidence shows that people with intellectual disabilities are not viewed by professionals within acute general hospitals as a vital source of information, neither are they often communicated with directly, nor involved in discussions or decisions about their health care and are frequently not directly asked for their consent. Method., A purposive sample of nurses working within the accident and emergency departments of five general hospitals was recruited to participate in this qualitative study. Data were collected from five focus groups. Findings., Effective communication was identified as the most challenging aspect in caring for adults with intellectual disabilities within this environment, having an impact on the assessment of needs, informing patients of their health status and seeking valid consent. Conclusions., Fundamental to the provision of quality care are the concepts communication, choice and control. However, these issues are perceived to be more challenging in the provision of health care to people with intellectual disabilities. Communication and consent, therefore, require further consideration within the educational and clinical areas to strengthen nurses' competence in caring for people with intellectual disabilities, with an emphasis and understanding that choice and control are key principles for all people, being central aspects to the provision of an inclusive service for people with intellectual disabilities. Relevance to clinical practice., All nurses need to have a greater awareness of learning disability, how to increase opportunities for effective communication and be very familiar with the issue and guidelines relating to consent, to ensure that people with learning disabilities have choice, control and are more active in decision making regarding their health. [source] | ||||||||||